This is a revised proposal to support leadership activities for the development of the capacity in aging research at the University of California San Francisco (UCSF) through the creation of an outstanding program in geriatrics research and the implementation of a systematic effort to create a university-wide community of researchers in aging. The proposal has three specific objectives: (1) To provide sustained support for development of a research and research training Program in Patient-Oriented Geriatrics Research to improve the processes and outcomes of care for older people, especially those with serious acute or chronic illness; (2) To provide sustained support for the development of a geriatrics research infrastructure, for opportunities for faculty development and collaboration, and for a systematic effort to create a university-wide community of researchers; (3) To integrate the new research and research training program in patient-oriented geriatrics research in the community of aging research in the Schools and Institutes of UCSF. UCSF provides an excellent environment for the development of academic geriatrics, and the university is strongly committed to this development. UCSF has well established research and training programs in the biologic, epidemiologic, and social sciences related to geriatrics. The commitment of substantial resources of money and space further strengthen the foundation for the development of academic geriatrics at UCSF. The Academic Career Leadership Award will be directed by C. Seth Landefeld, M.D. (Professor of Medicine, and of Epidemiology and Biostatistics). Dr. Landefeld has an extensive record of patient-based research and of programmatic development with the training and mentoring of young investigators. He joined UCSF in 1997 as Chief of the Division of Geriatrics and Director of the UCSF/Mt. Zion Center on Aging. Since then, Dr. Landefeld has led the foundation-building for the current proposal: interdisciplinary resources at UCSF have been identified; the Program in Patient-Oriented Geriatrics Research has been initiated with intramural and extramural start-up funding; and 20 outstanding faculty and post-doctoral trainees have been recruited. The sustained support of the proposed Academic Career Leadership Award is required to catalyze the further development of geriatric research and research training at UCSF.